Classify this panel two waysIs panel ko do tareekon se classify karo
Pick any scenario, then mark the grid yourself before revealing. Toggle to ROME any time to see the same panel explained the other way — most students end up preferring one for speed and the other for double-checking under pressure.Koi bhi scenario pick karo, phir reveal karne se pehle khud grid mark karo. Kabhi bhi ROME par toggle karke same panel ko doosre tareeke se explained dekho — zyadatar students speed ke liye ek aur pressure mein double-check karne ke liye doosra prefer karte hain.
For each row, click the column (Acidosis / Normal / Alkalosis) that value falls into. Two or three marks landing in the same column tells you the story.Har row ke liye, us column par click karo (Acidosis / Normal / Alkalosis) jisme value fall karti hai. Do ya teen marks ka same column mein aana story bata deta hai.
Respiratory = Opposite: pH and PaCO₂ move in opposite directions for a respiratory problem.
Metabolic = Equal: pH and HCO₃⁻ move in the same direction for a metabolic problem.
Pick a scenario to walk throughEk scenario pick karo jise walk through karna hai
All scenariosSaare scenarios
31 scenarios across all six acid–base categories — respiratory acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis, mixed/advanced, and reference panels. All 31 are free, including the advanced, trap, and mixed-disorder panels.Sabhi six acid–base categories ke 31 scenarios — respiratory acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis, mixed/advanced, aur reference panels. Sabhi 31 free hain, advanced, trap, aur mixed-disorder panels sahit.
Full clinical casesPoore clinical cases
Interpretation is only step one here. Each case adds the history, the vitals, and four follow-up judgment calls a real shift actually asks for — nursing priority, the sign that means "getting worse," the intervention worth questioning, and a ventilator or monitoring consideration — not just "name the acid–base disorder."Yahan interpretation sirf step one hai. Har case history, vitals, aur four follow-up judgment calls add karta hai jo ek real shift mein actually poochhe jaate hain — nursing priority, woh sign jiska matlab hai "getting worse," woh intervention jise question karna zaroori hai, aur ek ventilator ya monitoring consideration — sirf "acid–base disorder ka naam batao" nahi.
Before you read the panel: sampling & specimen handlingPanel padhne se pehle: sampling aur specimen handling
NORCET doesn't only test interpretation — real past papers have tested wrist positioning for the puncture and what happens to a sample that sits too long. This is the part most ABG tools skip entirely.NORCET sirf interpretation hi test nahi karta — real past papers mein puncture ke liye wrist positioning aur ek sample ka kya hota hai jo bahut der tak pada rahe, yeh bhi test ho chuka hai. Yeh wo part hai jise zyadatar ABG tools poori tarah skip kar dete hain.
Before puncture — A modified Allen's test checks that the ulnar artery can supply the hand on its own, so the hand isn't left dependent on the radial artery alone if it's injured during or after the draw.
Air bubbles — Purge any trapped air before capping the syringe. Room air's gas tensions are different from arterial blood, and equilibration with a trapped bubble can distort both PaO₂ and PaCO₂.
Specimen handling — Analyze promptly. Cells in the syringe keep metabolizing — a sample left unrefrigerated for a while drifts toward a falsely lower pH and falsely higher PaCO₂ as ongoing O₂ consumption and CO₂ production continue. Ice the sample if analysis will be delayed.
After puncture — Apply firm, direct pressure for several minutes (longer if the patient is on anticoagulants) — the radial artery is a high-pressure vessel and is more prone to hematoma than a venous draw. Site aur positioning — Radial artery preferred hoti hai kyunki hand ko usually ulnar artery se collateral supply milti hai. Wrist ko palm-up (supinated) position mein rakha jaata hai aur gently roughly 20–30° extend/dorsiflex kiya jaata hai, aksar ek rolled towel ke upar, taaki artery surface ke zyada kareeb aa jaye.
Puncture se pehle — Ek modified Allen's test check karta hai ki ulnar artery akele hand ko supply kar sakti hai, taaki agar draw ke dauran ya baad mein radial artery injure ho jaaye to hand sirf usi par dependent na reh jaaye.
Air bubbles — Syringe cap karne se pehle koi bhi trapped air purge kar do. Room air ke gas tensions arterial blood se different hote hain, aur ek trapped bubble ke saath equilibration PaO₂ aur PaCO₂ dono ko distort kar sakta hai.
Specimen handling — Turant analyze karo. Syringe ke cells metabolize karte rehte hain — agar sample kuch der ke liye unrefrigerated chhoda jaaye to ongoing O₂ consumption aur CO₂ production ki wajah se yeh ek falsely lower pH aur falsely higher PaCO₂ ki taraf drift karta hai. Agar analysis delay hoga to sample ko ice par rakho.
Puncture ke baad — Kai minute tak firm, direct pressure apply karo (agar patient anticoagulants par hai to zyada der tak) — radial artery ek high-pressure vessel hai aur ek venous draw ke comparison mein hematoma hone ka zyada prone hai.